Georgian medical news最新文献

Chronic obstructive pulmonary disease is a frequently occurring and common respiratory disease which has an incidence of 13.7% among people over 40 years in China, and now nearly 100 million people at home suffer from chronic obstructive pulmonary disease. To observe the effect of Low molecular weight heparin sodium in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) comorbid with pulmonary heart disease (PHD) on blood vessels.

Methods: A total of 92 patients with AECOPD accompanied by PHD in our Hospital from January 2019 to May 2021 were randomly divided into two groups. The control group was given basic treatment while the observation group was treated with basic treatment in combination with Low molecular weight heparin sodium. The changes of blood gas, hemorheology, cardiac function and serum factors were recorded to analyze their curative effect and safety.

Results: The total effective rate of the observation group was 95.65% (44 cases per 46 cases), which was significantly higher than that of the control group with 82.61% (38 cases per 46 cases), with statistical significance (P<0.05). The left ventricular ejection fraction (LVEF), 6-min walking distance (6MWD), arterial partial pressure of oxygen (PaO2), pH, nitric oxide (NO), and oxygen saturation (SaO2) in the two groups were higher than those before treatment while 4-hydroxymenealdehyde (4-HNE), endothelin-1 (ET-1), arterial partial pressure of carbon dioxide (PaCO2), brain natriuretic peptide (BNP), high-sensitivity-C-reactive protein (hs -CRP), tumor necrosis factor-α (TNF-α) and hemorheology indexes were decreased compared with those before treatment. After treatment, the improvement of the above indexes in the observation group was higher than those in the control group (P<0.05) with no significant difference in adverse reactions between them(P>0.05).

Conclusion: Low molecular weight heparin sodium can reduce inflammation and improve hemorheology by regulating the balance of blood vessels, thus improve the curative effect in the treatment of AECOPD accompanied by PHD.

Anti-cancer therapy with anthracyclines and trastuzumab has raised concerns regarding cancer therapy-related cardiac dysfunction (CTRCD) in breast cancer (BC) patients. This study aimed to assess left ventricular (LV) ultrasound parameters in BC postmenopausal women during a 2-year follow-up period after starting anti-cancer therapy.

Methods: We studied 74 women with early-stage BC with, a mean age of 62.3 (SD-8.6), who underwent adjuvant doxorubicin or doxorubicin + trastuzumab therapy. Parameters such as LV ejection fraction (LVEF), global longitudinal strain (LVGLS), and mitral annulus systolic velocity(S') were evaluated. Serial evaluations were conducted at baseline(T0) and the first (T1), second (T2), third (T3), sixth (T4), ninth (T5), twelfth (T6), and twenty-fourth month (T7) following the initiation of the chemotherapy. Cardioprotective therapy (CPT) was administered to high-risk patients and those with worsening LV systolic parameters. A multiple regression model was employed to assess the combined effects of various factors and co-factors on the outcome variables. Cardiotoxicity was evaluated using the survival analysis tools (Kaplan-Meier curves and Cox proportional model).

Results: A total of 27 (36.5%) patients developed CTRCD, although no patients were presented with symptomatic heart failure. LVGLS started to decline one month after the first anthracycline dose (T1) in 13.5% of the cohort and 34.5% of patients with CTRCD (p<0.000). From the third month, 10.8% of the patients showed a decrease in EF%, including 27.6% of patients with CTRCD in (P<0.000). Throughout, the study, S' remained within the normal range in patients without CTRCD, only patients with CTRCD showed a decline in S'.

Conclusions: This prospective study revealed that:1) The dynamic assessment of GLS should be prioritized for the early detection of systolic dysfunction .2) S' possesses a high diagnostic value for identifying cardiotoxicity. 3) Implementing the optimal medical cardioprotective strategies and closely monitoring LV systolic function can prevent serious cardiac complications in patients undergoing highly cardiotoxic anti-cancer treatment.

The aim is to evaluate ciprofloxacin toxicity in the liver and kidneys by assessing their functioning, histological alterations, and GFAP expression in chicks. In the acute trial, the chicks were divided into 3 groups of six. The 1st was the control. The 2nd and 3rd received injections of 250 and 500 mg/kg cipro. In the subchronic experiment, the animals were separated into two groups: the 1st group was control and 2nd groups were administered 125 mg/kg cipro for two weeks. The acute treatment at a dose of 500 mg/kg resulted in a significant increase in AST (alanine aminotransferase), ALT (aspartate aminotransferase), Mg (magnesium), and Ca (calcium), as did the subchronic trial at a level of 125 mg/kg. Acetylcholinesterase inhibition was measured at ciprofloxacin dosages of 250 and 500 mg/kg in the acute trial, as well as 125 mg/kg in the subchronic study. Histological examination revealed mild to severe lesions in the liver and kidneys treated with 250-500 mg/kg. The dose of 125 mg/kg resulted in significant coagulative necrosis of liver cells, sinusoidal enlargement, and severe inflammatory cell infiltration. Severe coagulative necrosis of the epithelial cells lining the renal tubules, and glomerular atrophy were all observed. Immunohistochemistry for GFAP in brain tissue showed a high positive result. We concluded that high doses of ciprofloxacin caused obvious biochemical and histological abnormalities in the liver and kidneys, cholinesterase inhibition in response to kidney and liver injuries, and increased glial fibrillary acidic protein (GFAP) expression in the brain.

Introduction: With COVID-19, there are isolated reports of a change in the free radical oxidation of blood lipids in the body of patients, however, the state of the half-AOS of saliva remains unexplored. At the same time, the editors of three scientific medical journals have already adopted the author's concept of the name of the disease - "COVID - 19 - POST-COVID SYNDROME".

Material and methods: The saliva of 63 patients with postcovid syndrome (PСS) served as the object of the study. The individual sensitivity of patients to xenobiotics was determined using the isoniazid method. According to the results of sensitivity to xenobiotics, patients were divided into groups: resistant, sensitive and very sensitive groups.

Results: Thus, the results of the conducted studies indicate a significant increase in the intensity of free radical lipid oxidation in postcovid syndrome, an increase in the prooxidant index of saliva associated with the sensitivity of the body to xenobiotics. The work carried out made it possible to determine the feasibility of using a medical leech for the rehabilitation of patients with PKS, depending on sensitivity to xenobiotics. The use of hirudotherapy inhibits the intensity of free radical oxidation processes, makes it possible to prevent the development of oxidative stress.

Conclusion: PKS is characterized by activation of the processes of lipoperoxidation of saliva, an increase in the content of primary, secondary and final POL products in it. The degree of increase in the prooxidant index in the saliva of patients with PKS depends on the sensitivity of the body to xenobiotics.

The study of individual anatomical variability has long attracted attention, with this topic being widely covered in the works of both domestic and foreign scientists. The aim of our work is to study the individual anatomical variability of the facial section of the skull, taking into account gender and craniotype, based on computed tomography data.

Material and methods: The material for our study consisted of 80 results from computed tomography (CT) scans of the human head, without any existing pathologies of the bone tissue.

Results: Brachycrania was established in males with a cranial index ranging from 80.6 to 92.4 (with x̄=86.68, σ=3.20, and mx̄=0.91), and in females from 80.2 to 88.3 (with x̄=84.32, σ=2.81, and mx̄=0.77). Similarly, mesocrania was confirmed by our data, with males showing a range from 76.8 to 79.2 (with x̄=77.93, σ=1.72, and mx̄=0.68), and females from 75.6 to 79.1 (with x̄=77.12, σ=1.74, and mx̄=0.59). Dolichocrania presented a variability range of cranial index values in adult males from 71.8 to 74.6 (with x̄=73.80, σ=1.52, and mx̄=0.63), and in females from 72.2 to 73.9 (with x̄=72.67, σ=1.48, and mx̄=0.59).

Conclusions: The individual anatomical variability of the facial section of the skull, taking into account gender and craniotype, based on computed tomography data was detected. Cranial profile characteristics of the facial skeleton are dependent on both gender and on the existing craniotype. We were able to establish clear differences between male and female skulls, particularly in terms of overall linear dimensions, the shapes of lateral polygons, and profilograms. A clear description of the brachycranial, mesocranial, and dolichocranial craniotypes was obtained, along with their relationships to other existing skull types.

The purpose of the study: Evaluation of the results of percutaneous drainage in the treatment of visceral and non-visceral fluid formations that developed in the abdominal cavity in the postoperative period.

Material and methods: The study involved 64 patients who underwent percutaneous drainage under ultrasound control, and 30 patients who underwent open surgical drainage. The clinical variables were analyzed along with the results of the interventions.

Results: The average hospital stay of patients who underwent open surgical drainage (11.10±3.42 days) was longer than that of patients who underwent percutaneous drainage (9.13±1.63 days). The average time of temperature decrease during percutaneous drainage was 4.31±1.75 days, and with open surgical drainage -4.94±2.01 days. Percutaneous drainage was successful in 96.8% of patients, and an unsuccessful result was observed in 3.2% of patients. In patients who underwent open surgical drainage, these rates were 80% and 20%, respectively. Compared with percutaneous drainage, complications were more frequent in patients who underwent open surgical drainage and amounted to 12.4% and 16.7%, respectively.

Conclusion: Percutaneous drainage under ultrasound control has a lower mortality rate compared to open surgical drainage, as well as reduces hospital stay and in most cases can replace drainage with traditional open or laparoscopic intervention.

Congenital pectus excavatum (PE) takes the first place among the deformation of the chest, accompanied by violations of the cardiorespiratory system and various cosmetic defects. A radical way to eliminate the deformation of the chest is surgical correction-thoracoplasty.

Material and methods: This study was performed on the results of surgical treatment of 183 patients with various forms of PE at the age of 3 to 18 years. All operated children were divided into three groups. The first group consisted of 76 (41.5%) patients who underwent thoracoplasty with fixation of the mobilized sternal-rib complex on an external traction splint. The second group included 77 (42,1%) patients operated by the developed method of thoracoplasty. The third group of 30 (16.4%) patients operated on the classical Nuss-method. Short- and long-term results were compared between the groups.

Results: The operation time was significantly shorter in third group (55 min) and the volume of blood loss was higher in the first group (46,4±12,5 ml). Pleural effusion and atelectasis were observed 4 and 3 patients and atelectasis, or pneumonitis was observed 3 and 2 patients in first and third groups respectively. The duration of postoperative pain syndrome was significantly shorter in second group with intercostal blockade. Pneumothorax was established 4 and 3 patients in first and third groups. Partial relapse and complete relapse were observed 3 (4.1%) and 2 (2.7%) patients in the first group.

Conclusion: Short and long-term results were excellent for modified thoracoplasty and Nuss procedures with low complication rates.

High prevalence of hypertrophic rhinitis makes more topical the problem of search of new, more effective means of treatment this pathology. 37 patients with hypertrophic rhinitis were examined. The clinical examination included the study of complaints and objective visual indicators associated with hypertrophic rhinitis. The olfactory function of the nose and the motor activity of the ciliated epithelium of the nasal mucosa were also studied. It has been established, that treatment intranasal electrophoresis with 5% potassium iodate solution caused attenuation, up to disappearance of the complaint, has a normalizing action on smelling function of nose, motor activity of scintillans epithelial of nasal mucosa and other objective indexes of clinical status. The above shown positive shifts were more positive in mild cases of hypertrophy.

The wide range of chemical structures of antioxidants provides opportunities for individual selection of the most suitable compounds, taking into account the unique needs and characteristics of the body. Synthetic antioxidants can be specially designed with certain characteristics, which helps to create more effective and stable compounds. The aim of this work was to conduct a series of studies to identify the antioxidant activity of newly synthesized compounds of a number of oxalic acid diamides based on 3,4-dimethoxyphenylcyclopentylamine N1 ((1-3,4-dimethoxyphenyl)methyl)-N2-(2-methoxyphenyl)oxalamide on the content of malondialdehyde (MDA) in the brain and liver tissues of white rats (in vivo, in vitro), as well as to determine their potential pharmacological properties that correspond to Lipinsky's "Rule of Five" (in silico).

Material and methods: The studies were conducted on white male rats weighing 180-200 g, kept on a normal diet. The brain and liver were washed with physiological solution, purified from vessels and homogenized in Tris-HCl buffer. The level of lipid peroxides was determined in a non-enzymatic peroxidation system by the yield of the final product - (MDA), which forms a complex compound with thiobarbituric acid in the form of a chromogen (trimethine complex).

Results and discussion: As a result of the conducted studies, it was established that the synthesized compounds exhibit antioxidant properties with varying degrees of effectiveness. The most pronounced activity was demonstrated by compound 1.24.50 both in liver tissue and in brain tissue. The least activity, both in liver tissue and in brain tissue, was demonstrated by compound 1.24.43. In addition, all physicochemical descriptors of the studied compounds correspond to Lipinsky's "Rule of Five". These data confirm the prospects of further studies of these compounds as potential sources for the development of new molecules for the treatment of oxidative stress.

Conclusion: Analysis of the obtained data allows us to conclude that the studied compounds demonstrate antioxidant properties, helping to protect cells from oxidative stress. These results are of significant importance for the prevention and treatment of diseases associated with increased levels of free radicals.

Smoking is one of the most common harmful habits that can lead to the development of pathological processes in various organs and systems. At the same time, smoking in childhood and adolescence especially contributes to the deterioration of the general somatic condition, increases the risk and determines the severity of the course of respiratory diseases, which in the future has an impact on the development and functioning of the respiratory system, becomes the cause of dependent conditions and complicates the course of accompanying pathology. It is believed that disruption of the microcirculatory channel can be one of the key links in the development of pathological processes in the oral cavity. Therefore, improving the quality of diagnosis of lesions of the microcirculatory bed of periodontal tissues in the early stages of the inflammatory process became the goal of our work.

Material and methods: All patients were divided into 2 groups: the main group adolescents from 14 to 17 years old who smoke, and the control group - adolescents who have never smoked. Determination of the degree of damage to the vascular bed of periodontal tissues in adolescents was carried out with using biochemical analysis of oral fluid to detect in it prognostic markers of microcirculation disorders in periodontal tissues with determination of the level of arginine, nitrates, citrulline, urea. The index of micro crystallization of oral fluid, the rate of saliva secretion and the pH of the oral fluid were detected also.

Results: The results and their analysis indicate certain differences in the biochemical profile of the oral fluid of adolescents who smoke and adolescents who do not have this habit. The following values of the investigated indicators were obtained. Interquartile indicators of the level of arginine in the main group are 6.19-13.63, in the control group - 9.01-12.12; nitrates - 98.2-174.84 and 96.3-179.39, citrulline - 10.20-17.39 and 7.31-14.38, urea - 10.2-15.9 and 11.1-17.7 in accordance with the specified procedure. Such a situation may indicate the presence of an early biochemical response, which appears some time before clinical manifestations, since individuals with an intact periodontium were selected for participation in this study.

Conclusions: Smoking is an unconditional factor that worsens the morpho-functional condition of the mucous membrane of the oral cavity not only in adults, but also in children. Yes, a reliable difference between smokers and non-smokers was determined for arginine and citrulline indicators; no significant differences were found between the parameters of nitrates and urea.